成人中与糖尿病前期相关的人体测量和双能X线吸收法得出的身体成分测量指标

Anthropometric and DXA-derived measures of body composition in relation to pre-diabetes among adults.

作者信息

Mohammad Anwar, Ziyab Ali H, Mohammad Talal

机构信息

Department of Biochemistry and Molecular Biology, Dasman Diabetes Institute, Kuwait City, Kuwait

Department of Community Medicine and Behavioral Sciences, College of Medicine, Kuwait University, Kuwait City, Kuwait.

出版信息

BMJ Open Diabetes Res Care. 2023 Oct;11(5). doi: 10.1136/bmjdrc-2023-003412.

DOI:10.1136/bmjdrc-2023-003412

PMID:37793678

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10551999/

Abstract

INTRODUCTION

Abdominal obesity is the most common risk factor of pre-diabetes and diabetes. Currently, several types of indices are used for the determination of visceral fat-related abdominal obesity. To better understand the effect of the different adiposity indices, we sought to evaluate the association of different adiposity measurements, assessed using dual-energy X-ray absorptiometry (DXA), and pre-diabetes.

RESEARCH DESIGN AND METHODS

This cross-sectional study included 1184 adults between 18 and 65 years who participated in the Kuwait Wellbeing Study. Anthropometry measurements included body mass index (BMI) and waist-to-hip ratio. Total body fat (TBF) mass, android fat mass, gynoid fat, and visceral adipose tissue (VAT) mass were measured using the Lunar iDXA. Pre-diabetes was defined as 5.7≤HbA1c%≤6.4. Adjusted prevalence ratios (aPRs) and 95% CIs were estimated. Area under the curve (AUC) was estimated for each adiposity measurement as predictor of pre-diabetes.

RESULTS

A total of 585 (49.4%) males and 599 (50.6%) females were enrolled in the study. Increased BMI (aPR =1.59, 95% CI: 1.19 to 2.12), waist-to-hip ratio (aPR =1.25, 0.96 to 1.61), TBF (aPR =1.58, 1.20 to 2.07), android fat (aPR =1.67, 1.27 to 2.20), gynoid fat (aPR =1.48, 1.16 to 1.89), android-to-gynoid fat ratio (aPR =1.70, 1.27 to 2.28), and VAT mass (aPR =2.05, 1.49 to 2.82) were associated with elevated pre-diabetes prevalence. Gynoid fat was associated with pre-diabetes among males (aPR =1.71, 1.22 to 2.41), but not among females (aPR =1.27, 0.90 to 1.78). Moreover, in terms of AUC, VAT had the highest estimated AUC of 0.680, followed by android-to-gynoid fat ratio (AUC: 0.647) and android fat (AUC: 0.646).

CONCLUSIONS

Pre-diabetes prevalence increased as adiposity measurements increased, with VAT mass demonstrating the highest AUC for pre-diabetes.

摘要

引言

腹型肥胖是糖尿病前期和糖尿病最常见的危险因素。目前，有几种类型的指标用于确定与内脏脂肪相关的腹型肥胖。为了更好地理解不同肥胖指数的影响，我们试图评估使用双能X线吸收法（DXA）评估的不同肥胖测量指标与糖尿病前期之间的关联。

研究设计与方法

这项横断面研究纳入了1184名年龄在18至65岁之间参与科威特健康研究的成年人。人体测量指标包括体重指数（BMI）和腰臀比。使用Lunar iDXA测量全身脂肪（TBF）量、男性型脂肪量、女性型脂肪量和内脏脂肪组织（VAT）量。糖尿病前期定义为糖化血红蛋白（HbA1c）百分比在5.7≤HbA1c%≤6.4之间。估计调整后的患病率比（aPRs）和95%置信区间（CIs）。估计每个肥胖测量指标作为糖尿病前期预测指标的曲线下面积（AUC）。

结果

共有585名男性（49.4%）和599名女性（50.6%）参与了该研究。BMI升高（aPR =1.59，95%CI：1.19至2.12）、腰臀比升高（aPR =1.25，0.96至1.61）、TBF升高（aPR =1.58，1.20至2.07）、男性型脂肪升高（aPR =1.67，1.27至2.20）、女性型脂肪升高（aPR =1.48，1.16至1.89）、男性型与女性型脂肪比率升高（aPR =1.70，1.27至2.28）以及VAT量升高（aPR =2.05，1.49至2.82）均与糖尿病前期患病率升高相关。女性型脂肪在男性中与糖尿病前期相关（aPR =1.71，1.22至2.41），但在女性中不相关（aPR =1.27，0.90至1.78）。此外，就AUC而言，VAT的估计AUC最高，为0.680，其次是男性型与女性型脂肪比率（AUC：0.647）和男性型脂肪（AUC：0.646）。